The present invention relates to endotracheal tubes for ventilation of the lungs, and more particularly to an improved double lumen endotracheal tube that allows for inserting both bronchial and tracheal lumens together and then separating and removing the bronchial lumen to allow for continued tracheal, ventilation.
Endotracheal tubes are used to couple a patient""s respiratory system to a breathing apparatus during surgical procedures or emergency situations. A typical endotracheal tube is made of PVA (polyvinyl chloride) or similar material and has an inflatable cuff positioned several centimeters from an end of the tube that is inserted into the trachea. Thus, the tube can be sealed relative to the trachea by inflating the cuff through an inflation line extending along the endotracheal tube. A fitting on an opposite end of the tube couples the endotracheal tube to an artificial respirator or ventilator. This type of device is well known to those skilled in the medical arts.
As is also well known to those skilled in the medical arts, a double lumen endotracheal tube is required in many kinds of lung or major vascular surgery when it is necessary to ventilate both the left and right lungs separately. A conventional double lumen endotracheal tube provides for individualized ventilation of the two lungs with two lumens each having a cuff positioned therearound. The bronchial lumen may extend into either the right or left mainstem bronchus while the tracheal lumen remains in the trachea. The usefulness of this conventional-type of double lumen endotracheal tube is limited by its large diameter which can unfortunately lead to bronchial damage and even vocal chord scarring when it is left in place for a long post-operative period. Thus, when post-operative ventilatory support is anticipated for a patient, the double lumen endotracheal tube is usually removed at the end of the operation and is replaced with a conventional single lumen tube. However, the conventional double lumen endotracheal tube can be associated with significant upper airway swelling due to massive fluid resuscitation during the course of a surgical operation. Under these circumstances, replacement of the double lumen endotracheal tube with a single lumen tube in order to attempt to minimize the aforementioned bronchial damage and vocal chord scarring can be a potentially hazardous and occasionally life-threatening procedure. This is due to the fact that it can be very difficult for an anesthesiologist to see the upper airway and vocal chords adequately to replace the single lumen tube in the swollen upper airway. If it does prove difficult for the anesthesiologist to replace the double lumen endotracheal tube with the single lumen tube, a patient may be threatened with hypoxia and asphyxiation, and death.
These shortcomings are overcome by the separable double lumen endotracheal tube of the present invention which meets a long-felt need for a double lumen endotracheal tube that poses less risk to a patient when upper airway swelling has occurred during the course of a surgical operation.
In accordance with the present invention, a separable double lumen endotracheal tube is provided comprising a first tubular member defining a first lumen therethrough. A separately formed second tubular member is provided that defines a second lumen therethrough and which is removably affixed to the first tubular lumen. Thus, the first tubular member can be removed from the airway of a patient while allowing the second tubular member to remain in a patient""s airway.
Also, a method is provided for intubating a patient with a double lumen endotracheal tube comprising the steps of providing a separable double lumen endotracheal tube comprising a first tubular member defining a first lumen therethrough and a second removably affixed tubular member defining a second lumen therethrough. The patient is then intubated with the double lumen endotracheal tube such that the first tubular member serves as a bronchial tube and the second tubular member serves as a tracheal tube. Next, the first tubular member is removed from a patient by separating and withdrawing the first tubular member from a patient such that the second tubular member remains in position in an intubated patient""s trachea.
Accordingly it is an object of the present invention to provide a double lumen endotracheal tube which allows for separation and removal of one lumen from a patient while allowing the other lumen to remain in place in an intubated patient.
It is another object of the present invention to provide a method for intubating a patient with a double lumen endotracheal tube that allows for removal of the bronchial lumen when post-operative ventilatory support is anticipated while leaving the tracheal lumen in place in the trachea of a patient.
It is another object of the present invention to provide a double lumen endotracheal tube which allows for tracheal intubation, followed by bronchial intubation, which is then followed by brochial extubation.
It is still another object of the present invention to provide a double lumen endotracheal tube which allows for intubating a patient with the tracheal lumen and then slidably attaching and inserting the bronchial lumen into place later in a patient, and then selectively sliding and removing the bronchial lumen from a patient.
It is still another object of the present invention to provide a double lumen endotracheal tube which includes a bronchial lumen and a tracheal lumen which are removably affixed and which double lumen endotracheal tube allows for positive pressure ventilation of each individual lung when both lumens are attached or of both lungs together when only the tracheal lumen is in place in a patient.
Some of the objects of the invention having been stated hereinabove, other objects will become evident as the description proceeds, when taken in connection with the accompanying drawings as best described hereinbelow.